Topic: how did you protect nipple after nipple reconstruction?

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

I am way ahead of myself here. Bilat mast with expanders. About two fills away from being "filled" then will have the exchange. I keep reading on the nipple reconstruction and how important to protect the nipples from being flattened for about 4 months. I can't imagine the nursing nipple guard made of plastic to be very comfortable all day long - sweaty and all. Also can't imagine how to conceal the little pylon cones without so much padding that I would look like a disfugured barbie doll. What creative ideas did you gal who have been throught this come up with? thanks a bunch!

I bought some cosmetic sponges and cut a hole in the middle. Just slipped them over the nipples and they protected them from rubbing or squishing from the bra. Mine healed very quickly and I only did that for 2 weeks. Mine were done with the star flap or c-v flap.

Have patience! You will get there!

When a woman tells the truth she is creating the possibility for more truth around her. Adrienne Rich

sbmolee, Keep in mind that the 4 months protection was my idea (from what I had read on the internet). I don't think too many PSs are recommending that. I just wanted to do everything I could to keep it from flattening since that seems to be a very common problem. My PS kind of chuckled at me for being overly protective....LOL. As for the plastic shields, they have ventilation holes in them. They weren't the most comfortable thing but were better than the foam doughnuts that my PS sent me home with. The nursing pads with the hole in the center were the easiest to conceal but I waited until I was pretty well healed before I used them. I liked the bunion pads for night time so if I rolled onto my nip, I wouldn't wake up screaming.......'OH MY GOD, I've FLATTENED MY NIPPLE".......the Amish across the road would have REALLY shunned me!!! ROFL! There are some nipple after care instructions on www.breastreconstruction.org too. Best wishes

Did you have to stack several sponges? I bought some (way in advanced to be ready!) but they don't seem very thick enough. Did you also use the plastic nursing nipple guard as well under the sponge? thanks

Live life to the fullest - it is not a spectator sport.
Dx
3/27/2008, DCIS, 2cm, Stage Ia, Grade 3, 0/2 nodes, ER+/PR+, HER2-

Well -- I did exercise some creativity -- which I can share while ADVISING YOU OF THE PITFALLS I discovered...

I got these round makeup sponges...

I actually got CVS house brand "Essence of Beauty" but I can't even find them on the CVS site! But they looked pretty much like this:

Then I cut a big-enough hole out of the center of 2 of them, stacked the 2 on top of each other and placed them on foob so fipple was in the hole in middle. BUT WITH PLENTY OF CLEARANCE, SO THE FIPPLE DOESN'T TOUCH THE SPONGE!!!

You might need to stack 3 to make sure nothing touches the top of your fipple. I taped these in place with paper tape. But I didn't put tape across the hole in the middle. Once I had the sponges in place, I kind of draped a new sterile gauze square over the opening (these are also called "sponges", or "toppers", but they're gauze bandages). Early on, I taped the gauze square at its edges, but as time and healing progressed I just set it on top.

I wore the hard plastic thing-y for 2 weeks, but then I invented this sponge system, especially for dates.

THE CAVEAT: I would NOT wear this for more than 2 or 3 hours at a stretch. I would NOT wear any kind of tight or compressive bra or camisole over it.

(I wore it for about 10 hours one day, with a compressive bra on top, and it caused the sponges to really press down too hard -- the nipple looked fine, but the skin surrounding it was kind of purplish and indented. Looked like an areola tattoo in a weird color -- freaked me out. It all bounced back in a few hours, but... DO AS I SAY, NOT AS I DID! Don't work a 10-hour day wearing this, at least not with a compression bra!)

I showed my "rig" to my plastic surgeon, who was impressed with the invention. I kind of got the idea from RubyTuesday, who mentioned bunion or corn pads -- I bought those first, but the ones I found didn't look big enough, so I moved on to the cosmetic sponges.

Anyway, you might want to run this by your PS. Also, this is definitely for the time AFTER anything open has healed, because the sponges are not sterile. They're clean, but not sterile, so they're not appropriate when you still have a wound. And even then, I would not re-use sponges, but use clean ones every day.

Finally, my nipple recon was by the "C-V flap" or "twist" method -- I would NEVER, NEVER, NEVER use this on a nipple/areola that is grafted using tissue from another part of your body.

EDIT: It took me so long to write this! There were only 2 posts here when I started! Kathy was much more concise! Hi RubyTuesday!

ruby - you make me chukle! I have also read to protect for months and plan to do cuz I want nipples! I did ready about a product by asteame - The Nipple Guard is a protective, reinforced bandage that lessens compression, shear, and tensile forces, mainly due to scar tissue contraction on the new nipple; allowing the nipple to heal in an upright / erect position. They recommend wearing for 16 weeks. Sounded great but my goodness the cost for both nips for 16 weeks (bilat mast) was $1700.00!!! I can get really creative for alot less money!

Live life to the fullest - it is not a spectator sport.
Dx
3/27/2008, DCIS, 2cm, Stage Ia, Grade 3, 0/2 nodes, ER+/PR+, HER2-

That's expensive! Some use Dr. Scholl's bunion pads or something like that. The best thing about the cosmetic sponges is that they are cheap - 12 for under $1.50. They are actually pretty thick and protect pretty well.

When a woman tells the truth she is creating the possibility for more truth around her. Adrienne Rich

sbmolee, That's the same website I was reading and my intention was to have my PS see if she could get my insurance to pay for those but since my PS is 2+ hours away and my fipple surgery kind of snuck up on me, I never did try that route but I think it's worth a shot. Corn pads won't work...the hole isn't big enough....VERY SCARY BUT TRUE!!! If you are going to use those kind of 'stackers', you'll need bunion pads and make sure they are UNMEDICATED!!! You don't want them eating off your new fipple!! Bet you didn't realize how very complicated 'Fipples 101' could be!!! Best wishes

Chuckling again! Better than medication! Maybe we should hold a Fipples 101 class or chat room. I also bought bunion pads and already stacked them...mind you - I have not even had the exchange but am ready for the nip job. I even bought these round sponges at the craft store. They look like the Target store sign with circular pieces of sponges - then I popped out the center circle. It just might work but is about 3 inches thick - tried in my bra and WOW pretty full. May try to slice down a bit.

Live life to the fullest - it is not a spectator sport.
Dx
3/27/2008, DCIS, 2cm, Stage Ia, Grade 3, 0/2 nodes, ER+/PR+, HER2-

sbmolee, I do believe you are head (or ahead ) of your class!!! LOL You are sooo prepared!!! I think you might want to trim the 'target' sponges....that will be too funny! You might be able to cut them in half and use half for each side????? Best wishes!

I used Dr Scholl's bunion pads doubled during day at work but post op to protect nipples the surgeon used 3 ml syringes that only the top part by the plunger was cut off for about a half inch. The sides or wings of the plunger distributed the weight and the cut off length of the shaft of the syringe protected the nipple itself. I didn't want to go to work with the plastic pieces but did tape them up to protect them when home and sleeping.

Hi Ladies This is a creative group.! I had my nipple done 6/16. I left the bandaging up to my ps as he claimed ownership of the nipple until he felt it was healed. Mine was done with a graft. He just used several 4 x 4 gauze pads with a hole cut out in the center piled until the top of the nipple. Then he placed two more pads over those and ran a piece of tape across it. I was allowed to wear a regular bra immediately. After about two weeks he said no more bandages needed. My nipple wasn't huge as some other women describe but was bigger than my natural side. My ps actually wanted me to go without bandages to flatten it slightly. It's been about a week without and all is well. It flattened slightly but actually seems to pop up slightly when I remove the bra. I still have stitches waiting to dissolve.

This thread is so creative! I wish I would have found it 2 years ago. My PS cut what looked like a large straw into pieces and placed around the new nip. It helped keep it upright while it healed. Unfortunately, when the stitches came out, the nip flattened out. I'm not real happy with it but don't know what to do. I was going to ask the PS that will do my mast & recon on 8/4 if she would fix it but I'm not sure if she can. With the recon I'm having, the nipple is formed at the same time as the tissue is implanted into the breast envelope. We'll see. I don't often go bra-less so it really doesn't matter I guess. The sponges are a great idea. Good going ladies!

Read on a thread from a few years ago that having nip surgery flattened out the breast mound somewhat. Is this true - wondering from those that opted for nips if and how much this surgery flattened out the front of the boob?

Thanks

Live life to the fullest - it is not a spectator sport.
Dx
3/27/2008, DCIS, 2cm, Stage Ia, Grade 3, 0/2 nodes, ER+/PR+, HER2-

My PS put a surgipad dressing with a hole cut in the center on my new nipple. The pad was folded into thirds. He recommended stacks of gauze pads or even a sanitary napkin. I happened to already have the surgipads, so that is what I am using.

I don't get it --my PS said nothing about protecting the nipple -- do you think that is because it is going to flatten out anyway. I was sent him with absolutely no dressing -- just the plastic surgery glue over everything -- was told I could shower etc.

Unfortunately, my nipple is already significantly flattened and maybe in my case that's a good thing because I think it is too low. I have a lot of brownish reddish scabby stuff on the top so I am assuming part of the nipple failed. So far now, I put a gauze pad over it -- my bra is not really tight emough to push on it and I am awaiting the final result. What will be left when the scab falls off?

Thanks priz47 - I may have to reconsider...I don't care if the nips themselves flatten out a bit but my foobs are already a bit flat across the front (where the areola and nipple should be). It this flattens more I would be sad.

Live life to the fullest - it is not a spectator sport.
Dx
3/27/2008, DCIS, 2cm, Stage Ia, Grade 3, 0/2 nodes, ER+/PR+, HER2-

sbmolee- I can't imagine that happening-- it doesn't make sense. The nipple should give you the added projection you need to fill out gapping fabric in a bra, and to complete the breast.

As far as caring for nipples-- essential rules...

1. do not remove, play with, or even sneak a peek at the dressing that your surgeon has put on you after surgery.

2. When the bandage comes off, you should have an idea of what to expect-- discoloration, a big nipple that is swollen, scabs, stitches sticking out, etc. Dont panic.

3. The first two to three weeks are the critical ones. You don't want to compress the nipple. So whether you use the Dr scholl pads, or stack gauze and wear loose tops, its essential not to compress the nipple.

4. If your breast was radiated, you should have a reasonable expectation for the nipple. Sometimes it is harder to achieve a lot of volume, and projection, depending on the skin on the breast mound.

5. Nipples take a long time to totally heal and look normal, and even at that- the tattoos can further enhance the look of the nipple and areola, and can make a perfect circle for the areola as well.

6. At about 6 weeks the nipple is usually at the desired size. It will flatten. This is a fact. But, many women will tell you, that even if the nipple flattens over time, it still makes the breast look very real.

There are a lot of options to give projection to a flattened nipple. The most common are a dermal filler injection-- but now, surgeons that work with AlloDerm and Strattice are using them to give nipples lasting projection.

The care that goes into nipples and tattoos can be frustrating. It's technically the easy part surgically, but it takes a lot of after care.

Bandages? What bandages? I just don't get it -- my experience wasn't even close to what Beth explained. I never even had a bandage -- could see the ugly thing right from the get go -- as described. It's still scabby and getting flatter by the day even though I take care not to squish it.

Nope - nothing -- I had surgical glue and that was it. I still have some of the glue and I haven't touched it or tried to peel it off because the nipple is all scabby. It also looks like it bleeds a little sometimes -- there are very small spots of blood on the gauze pad I covered it with. PS told me not to be concerned if it oozed. It is definitely not oozing though, just tiny spots of red or perhaps it's part of the scab. I am beginning to think that I have a failed nipple and my PS just didn't want to say so yet. Told me not to touch it and to come back in 4 weeks. I will be interested to hear what he has to say then. And I'm not as upset about it now -- since I don't like the placement, I'm might be glad that it is flattened, but I hate to have gone through yet another surgery all for nothing. I also have new scars on the flap where the nipple was made -- they are horizontal on each side of the nipple and fairly noticeable. I will be upset if the nipple fails and all I get is an additional scar.

LOOK NO FURTHER GALS! The absolute BEST and inexpensive thing I've found to protect the nipple are good ole Dr. Scholl's callus cushions! I got this tip from Lillie Shockney at Hopkins, and they are GREAT! They are a perfect circle, with perfect size circle already cut out, so you don't have to cut anything out, they're ready to go! And they're already sticky (I stick two together), and was taping them on with bandage tape at first, but since my stitches have healed, I just stick them right on to my skin! They come in packs of 8 for about $2.85 at Wal Mart, and since I use 4 at a time, one "set" will last me about a week. The stickyness goes away after a while, so then I tape them on.

My PS recommends protecting them for 3 months. I'm just over 2 months now. I will be SO glad when I don't have to do this everyday anymore, but the callus cushions work GREAT! Quick and easy! And cheap! I can't believe people would actually pay the $1700 for those nipple guard things!

I used the sponge that is used to protect the coccyx against decubitus ulcers, a bit thick but worked well, it is adhesive on one side so I put a gauze pad and cut a nipple hole out of it and stuck the adhesive side of the sponge on the breast and then put the bra on. That worked well for me. The nipples were huge in the beginning, I thought they looked like 2 noses lol.

I am a lactation nurse and we use things called, amazingly, nipple shields, for mom's with flat or inverted nipples. They are softish silicone with holes in the end to let the milk out, so they aerate nicely. They are by Medela. I am sending some to NOLA because they worked so well, I cut a bit off the end so wound could get even more air. They provided just the right amount of protection. I swear, I have not stock in this company (!). You can buy tham at Target. Worked great for me, and I love my new nipples.